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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of intravenous dopamine were evaluated in 10 patients with severe but stable coronary artery disease, 17 consecutive patients with primary cardiogenic shock and 3 with severe congestive heart failure and oliguria. Dopamine infusion at 10 mug/kg.min in the 10 patients increased cardiac output by 35%, left ventricular peak dP/dt by 38%, left ventricular minute work index by 44% and mean systolic ejection rate by 7% (P < 0.01); heart rate, aortic pressure, left ventricular end-diastolic pressure and tension-time index were unchanged. For oxygen, potassium and lactate, arterial and coronary sinus values, coronary arteriovenous oxygen differences and myocardial extraction were unchanged. Hemodynamically 13 of the 17 patients in shock responded favourably to dopamine infusion (0.5 to 15 mug/kg.min), with decrease in heart rate, increase in systolic arterial pressure from 75 to 100 mm Hg (P <0.001), decrease in ventricular filling pressure from 20 to 16 mm Hg (P < 0.01) and increase in urine output from 10 to 100 ml/h (P < 0.01). Eleven of those patients survived the shock episode. A close relation was observed between the hemodynamic response to dopamine, survival from the shock episode and the time between onset of shock and initiation of therapy. Low rates of dopamine infusion induced diuresis in the three patients with severe cardiac failure.Dopamine thus seems to improve the mechanical efficiency of the heart in coronary artery disease. Cardiac output is selectively increased and myocardial ischemia does not appear to be induced; those beneficial effects as well as presumably specific action on renal flow and natriuresis, improve immediate survival from cardiogenic shock and severe heart failure.
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PMID:Hemodynamic and therapeutic effects of intravenous dopamine. 60 65

Dopamine was used as the primary catecholamine to treat circulatory shock, manifested by either systemic arterial hypotension or oliguria or both, in 24 children two days to 18 years (mean = 39 months) of age. The dose of dopamine ranged from 0.3 to 25 (mean = 9.3) microgram/kg/minute. The primary problem in four of the 24 patients was infection; two of these patients survived. The other 20 patients had congenital heart disease; 18 developed shock following surgery. Even of these 20 patients survived. With dopamine infusion the average systolic blood pressure increased from 69 +/- 4 (mean +/- SEM) to 81 +/- 4 mm Hg (P less than 0.001) and the mean urine output increased from 0.8 +/- 0.2 to 2.7 +/- 0.8 ml/kg/hour (P less than 0.05). Dopamine produced no adverse consequences. Thirteen patients responded favorably to the drug, with a significant increase in systemic arterial blood pressure and urine production. Four patients did not respond to dopamine and seven had an equivocal response. None of the four patients in whom dopamine was ineffective survived. Although only nine of the 20 patients who responded favorably or equivocally survived, conventional therapy had failed to alter the unfavoarble course in any of the patients.
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PMID:The use of dopamine in children. 62 15

Oliguria in pre-eclamptic women is most often a result of decreased intravascular volume. In a small number of patients, renal vascular spasm may be the cause of decreased urine output. Prolonged oliguria/anuria secondary to vasospasm may lead to permanent renal damage. When volume repletion is unsuccessful in restoring urine output, some authors have suggested the use of peripheral vasodilators such as hydralazine. Dopamine in low doses 2 micrograms/kg per min was used successfully to restore urine output within an hour in a pre-eclamptic patient who had been essentially anuric for 8 h. Volume administration and hydralazine were unsuccessful. In the rare instance of a patient who is unresponsive to conventional methods, low dose dopamine may provide an adjunctive therapy to restore urine output after delivery. Central monitoring is essential in following such patients.
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PMID:Low dose dopamine in the treatment of persistent oliguria in pre-eclampsia. 196 19

The definition and classification of the various forms of circulatory shock are outlined, together with the causes and management of cardiogenic shock. The pharmacotherapeutic possibilities in patients with shock following myocardial infarction are discussed: over the last 15 years several alpha and beta adrenergic stimulants, as well as alpha-blocking agents, have been included in the treatment of this severe circulatory failure; today the most commonly used drugs in cardiogenic shock are dopamine and dobutamine, sometimes in combination with vasodilators. Dopamine appears to be indicated when low cardiac output, arterial hypotension and oliguria are present; dobutamine, a positive inotropic acting drug, should be used when arterial hypotension is only moderate but combined with elevated filling pressures. Despite the various therapeutic approaches the mortality of cardiogenic shock, which reaches 10-15% of patients with acute myocardial infarction, is still high (70-90%); an improvement may be expected with newer forms of therapy (fibrinolysis, dilatation). Finally, a concept for the management of cardiogenic shock following myocardial infarction is presented.
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PMID:[Pharmacotherapy of cardiogenic shock]. 289 69

Acute oliguria in the critically ill postoperative patient, or in the trauma victim after resuscitation, is a substantial clinical problem. The mortality associated with ARF in these settings remains unacceptably high. Evaluation of the oliguric patient must include thorough monitoring for, and correction of, prerenal and postrenal causes of oliguria. In this sense, diagnosis of ARF is one of exclusion. Differential diagnosis is facilitated by microscopic examination of urine and by biochemical analyses of blood and urine for calculating indices of tubular function (urinary-to-plasma ratios of blood urea nitrogen and creatinine, sodium excretion, and clearances of sodium, creatinine, solute, and water). The early detection of an intrarenal defect, as accomplished by using serial measurements of free water clearance, may allow interruption of the process and prevention of ARF. Preventive measures include optimization of hemodynamic status and the use of osmotic diuretic agents (mannitol) and loop diuretics (furosemide, ethacrynic acid, and bumetanide). Dopamine is useful for increasing both renal blood flow and urine flow and may be useful for preventing ARF, but this is not firmly established. Experimentally, other approaches such as modulating the renin-angiotensin system, prostaglandin system, and cellular calcium fluxes have been attempted, but the clinical applicability of these measures is not established. The best approach to ARF is preventing it by knowing which patients are at high risk, by studiously preventing renal insults, and by aggressively treating early indications of renal malfunction using established therapies.
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PMID:Acute renal failure following traumatic injury or major operation. 355 12

The combined application of Tolazoline and Dopamine for the treatment of the persistent fetal circulation syndrome showed that Dopamine prevented the most common side effects of Tolazoline i.e. systemic hypotension and oliguria. The authors emphasize the importance of continuous monitoring of the systemic blood pressure in infants during this treatment.
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PMID:[Tolazoline and dopamine in the treatment of the persistent fetal circulation syndrome]. 664 41

Hemodynamic and renal function response to low-dose (100 and 200 micrograms/min) dopamine infusion was studied in 15 adult cardiac surgical patients who manifested combined oliguria and left ventricular dysfunction postoperatively. Patients were studied an average of 6.6 h after ICU admission, at normothermia and after 2 consecutive hourly urine output determinations of less than 0.5 ml/kg . h in the presence of a left atrial or pulmonary artery occlusion pressure over 12 mm Hg. Dopamine infusion at 100 micrograms/min produced improvement in creatinine, osmolar and free water clearances (70 +/- 10 to 115 +/- 13, 37 +/- 4 to 93 +/- 16 and --15 +/- 2 to --37 +/- 10 ml/min, respectively), and urinary sodium concentration (15 +/- 5 to 29 +/- 10 mEq/L). Urine flow improved overall from 22 +/- 2 to 54 +/- 9 ml/h; however, in 9 of 15 patients, flow was less than 0.5 ml/kg . h (33 +/- 5 to 50 +/- 6 ml/h). In each of these 9 patients, dopamine infusion at 20 micrograms/min further improved urine flow as well as measured renal function. Plasma renin activity measured in 9 of the 15 patients before and during the 100 micrograms/min dopamine infusion was decreased from 1.95 +/- 0.57 to 0.73 +/- 0.39 ng/ml . h. The hemodynamic effect of both dopamine doses was increased cardiac output coupled with decreased systemic (SVRI) and pulmonary vascular resistance index (PVRI). In these 15 patients, low-dose dopamine infusion produced significant improvement in renal function, with resolution of oliguria in every case, and with no deleterious hemodynamic effect.
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PMID:Acute oliguria after cardiopulmonary bypass: renal functional improvement with low-dose dopamine infusion. 714 Mar 33

Patients undergoing surgery for idiopathic scoliosis were studied to determine the incidence and aetiology of oliguria during the perioperative period and to evaluate the efficacy of low dose dopamine in preventing its occurrence. Thirty patients, aged 6-18 years undergoing elective surgery were studied. Anaesthesia was standardized. Patients were randomized to receive either dopamine infusion (3 micrograms.kg-1.min-1) (Group A) (n = 15) or dextrose infusion (control) (Group B) (n = 15). Serum and urinary electrolytes and osmolalities and serum antidiuretic hormone (ADH) concentrations were measured. Urine output and haemodynamic parameters were recorded. Intraoperative oliguria occurred in 7% of patients in Group A and 47% in Group B (P < 0.05). Postoperative oliguria occurred in 20% of patients in Group A and 47% in Group B (P > 0.05). Urine and serum biochemical analysis revealed a statistically significant decrease in serum sodium and osmolality (P < 0.005) and an increase in urinary sodium and osmolality in both groups. Serum ADH concentrations were increased in both groups (P < 0.05), returning to baseline 18 h postoperatively. We conclude that oliguria during corrective spinal surgery occurs in association with excess ADH secretion as opposed to perioperative hypovolaemia. Dopamine increases urine output in the perioperative period but does not prevent the release of ADH and its subsequent biochemical effects.
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PMID:Oliguria during corrective spinal surgery for idiopathic scoliosis: the role of antidiuretic hormone. 1059 54